Dystonia

People with dystonia experience abnormal, involuntary muscle contractions that cause twisting and repetitive movements. Dystonia is caused by abnormal activation of cells in the brain. It is the third most common movement disorder (after essential tremor and Parkinson's disease), and affects more than 300,000 people in North America.

Neurologists at NewYork-Presbyterian Hospital's two movement disorder centers, Columbia's Center for Parkinson's Disease and Other Movement Disorders and Weill Cornell's Parkinson's Disease and Movement Disorders Institute, have extensive experience in the diagnosis and treatment of dystonia.

Symptoms

The primary symptom of dystonia is involuntary muscle contractions which force certain parts of the body into abnormal, sometimes painful, movements or postures.

Diagnosis

NewYork-Presbyterian physicians diagnose dystonia through a thorough physical examination and neurologic assessment to determine what symptoms are present and when and how they occur. They may order other tests, such as MRI scans, to rule out other causes of symptoms.

Medical Treatment

NewYork-Presbyterian provides comprehensive treatment for people with dystonia. The goal of therapy is to decrease muscle spasms, pain, and awkward postures, and improve patients' quality of life. Our doctors may try a number of different treatments or combinations of therapies before finding the approach that is most effective for each patient.

Oral medications used to treat dystonia include those that affect the neurotransmitter chemicals involved in the control of muscle movement. These medications may include drugs that alter the levels of certain brain chemicals that are important for normal movement.

Our neurologists also treat some patients with dystonia using botulinum toxin therapy (Botox®), a safe and effective treatment that can relax affected muscles for several months, and allow patients to maintain more normal posture and movement. We collaborate with members of the Department of Otorhinolaryngology (Ear, Nose, and Throat) to provide botulinum treatment for people with spasmodic dysphonia (dystonia affecting the voice).

Surgical Treatment

"Deep brain stimulation" (DBS) has become an important tool in the treatment of dystonia. NewYork-Presbyterian is one of the busiest and most prestigious centers offering this treatment. With DBS, neurosurgeons implant a device that acts like a pacemaker for the brain, reducing abnormal brain activity in dystonia and minimizing spasms. DBS also enables many patients to reduce their dependence on medications, which over time may cause unpleasant side effects.

Rehabilitation

Physical, occupational, speech, and nutritional therapy can all be helpful to patients with dystonia. Special equipment can help patients communicate effectively, remain mobile, and ensure their safety. Rehabilitation specialists are available at NewYork-Presbyterian to:

Evaluate muscle strength and motor skills and develop an individualized program to maintain existing physical function.

Recommend devices (including neck supports, canes, walkers, and wheelchairs) and equipment for the home to ensure patient's safety and mobility.

Some patients with dystonia find that complementary therapies (such as yoga, meditation, Pilates, biofeedback, and acupuncture) are also helpful in relieving their symptoms.

Research and Clinical Trials

Investigators at both NewYork-Presbyterian Hospital campuses are conducting basic science and clinical research to learn more about the causes of dystonia and to find new and more effective ways to diagnose and treat it.